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The key considerations include: The stage and severity of liver disease simple steatosis versus NASH, fibrosis, or cirrhosis Overall liver function as assessed through blood tests and clinical evaluation Concurrent chronic alcohol misuse which significantly increases hepatotoxicity risk, particularly in those who are fasting or malnourished Other medications being taken that may affect liver metabolism, including enzyme-inducing drugs (such as carbamazepine, rifampicin, or St John's wort) Adherence to recommended dosing never exceeding maximum daily limits Patients with known fatty liver disease should discuss paracetamol use with their GP or hepatologist, who can assess individual risk factors and provide personalised guidance

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